Promoting Patient-Centered Counseling to Reduce Inappropriate Diagnostic Tests

Not Applicable

Completed

• Conditions: Osteoporosis; Primary Care; Headache; Low Back Pain; Magnetic Resonance Imaging; Unnecessary Procedures

• Registration Number: NCT01808664
• Lead Sponsor: University of California, Davis

Brief Summary

In this study, the investigators will develop and evaluate a novel intervention using standardized patients (SPs) -- or actors playing the roles of patients -- to enhance physicians' patient-centered counseling skills regarding two frequently overused, potentially inappropriate services in primary care: magnetic resonance imaging (MRI) for acute low back pain and bone densitometry in women at low-risk for osteoporosis. The investigators will further evaluate whether intervention effects on physician patient-centeredness generalize to counseling regarding other costly, unnecessary diagnostic tests.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2012-11-20
• Study First Submitted QC: 2013-03-07
• Study First Posted: 2013-03-11
• Study Start: 2013-04
• Primary Completion: 2014-09
• Study Completion: 2014-12
• Status Verified: 2020-02
• Last Update Submitted: 2020-02-24
• Last Update Posted: 2020-02-26

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 61

Inclusion Criteria

• Resident physician in family medicine or internal medicine who deliver primary care at one of two hospital-based primary care clinics at the University of California, Davis Medical Center Sacramento

Exclusion Criteria

• Anticipated graduation in less than one year from enrollment.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Number of inappropriate diagnostic tests ordered	9 months	Investigators will assess via blinded, standardized chart review whether study physicians ordered inappropriate diagnostic tests for unannounced standardized patients who request testing during three follow-up visits occurring 3 to 9 months post-randomization.

Secondary Outcome Measures

Name	Time	Method
Use of patient-centered counseling techniques	9 months	Physician use of patient-centered counseling techniques as assessed via masked recordings of three standardized patient visits
Actual diagnostic test ordering among real patients	9 months post-intervention	Among real patients seen by study physicians, we will assess diagnostic test ordering among actual adult patients during the post-intervention period. We will also assess comparable diagnostic test ordering during the pre-intervention period to enable adjustment for baseline test ordering.